Provider Demographics
NPI:1093695926
Name:ZARATE, BANEZA
Entity type:Individual
Prefix:
First Name:BANEZA
Middle Name:
Last Name:ZARATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 HAVEN AVE APT 10306
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6980
Mailing Address - Country:US
Mailing Address - Phone:979-985-9107
Mailing Address - Fax:
Practice Address - Street 1:8200 HAVEN AVE APT 10306
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6980
Practice Address - Country:US
Practice Address - Phone:979-985-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst